Its now been a year since the disappearance of my viral load (from a peak of 3.3 million) and the unexpected return of my energy, sense of well-being, and confidence in my future. And it has been a most extraordinary year.

The large purple KS splotches that covered my face and neck are entirely gone. My CD4+ cells have gone from single digits to over 200, Ive gained almost thirty pounds, and I can now plan past the next phase of the moon.

I feel renewed, and I enjoy--with an almost childlike exuberance--revisiting places, experiences, and sensations I thought were forever part of my past. I appreciate life even more and am humbled by my own inexplicable survival, even though I already miss the lack of expectations and judgment often granted to the dying.

Im grateful, to be sure, but fine-tuning my treatment took considerable effort. Learning to manage side effects and reconfiguring lifelong daily patterns to accommodate compliance requirements were difficult tasks. At times, they seemed insurmountable. When doubled over from nausea, climbing the walls from anxiety, or searching out the third pair of clean underwear in one day, survival just didnt seem like that great a treat.

HIV has been the greatest challenge of my life. If I also had to face poverty, addiction, homelessness, mental illness, racism, caring for sicker family members, the responsibility of raising children, or other serious challenges on a daily basis, Im certain I could not have focused so intently and successfully on treating my HIV.

For many of us with protease-improved health, the challenge now is not simply survival per se but a survival that incorporates the lessons about compassion and love we learned when we were dying, in a manner that helps others survive as well.